Bipolar II Disorder

Symptoms | Causes | Diagnostic Criteria | Treatments

Bipolar II disorder is a mood disorder characterized by periods of hypomania and major depression. The main difference between bipolar II disorder and bipolar I disorder, is that with the former, mania is not as severe, but is instead expressed as hypomania.

According to the DSM-5, a hypomanic episode is defined as a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.

In contrast, a manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).


Symptoms of Bipolar II Disorder

Experiencing a hypomanic episode

  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual
  • Increase in goal-directed activity

Experiencing a major depressive episode

  • Depressed mood most of the day
  • Diminished interest in activities once enjoyed
  • Loss of energy nearly every day
  • Feelings of worthlessness
  • Recurrent thoughts of death/suicidal ideation

Causes of Bipolar II Disorder

Temperamental, environmental, genetic & physiological factors are all likely to play key roles in the development of bipolar II disorder. Individuals with a family history of mood disorders may be at a higher risk for developing it themselves.

According to the DSM-5, the risk of bipolar II disorder tends to be highest among relatives of individuals with bipolar II disorder, as opposed to individuals with bipolar I disorder or major depressive disorder.

Moreover, this mental illness most often begins with a depressive episode and is not recognized as bipolar II disorder until a hypomanic episode occurs; this happens in about 12% of individuals with the initial diagnosis of major depressive disorder.


Diagnostic Criteria

To get diagnosed with bipolar II disorder, one must undergo a psychiatric evaluation by a licensed mental health professional. This will often entail the therapist asking the patient numerous questions to better understand their family history, current symptoms, as well as the severity of those symptoms.

Bipolar II disorder is characterized by a clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic episode. The major depressive episode must last at least 2 weeks, and the hypomanic episode must last at least 4 days, to meet the diagnostic criteria, according to the DSM-5.


Treatments for Bipolar II Disorder

While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods of time, which can cause significant impairment with substantial consequences. The types and doses of medications prescribed are based on one’s particular symptoms, according to Mayo Clinic.

Depending on the severity of those symptoms, hospitalization may be required to treat bipolar II disorder. In any event, talk therapy and psychiatric medication are often used in unison to treat this condition.


Talk therapy or psychotherapy is a very common treatment method for bipolar disorder. During therapy, the therapist will work with the patient to help lower the frequency and intensity of their symptoms. Sometimes, treatment can take the form of group therapy.


Antipsychotics, mood stabilizers, and antidepressants are often used to treat bipolar disorder. Examples of antipsychotics include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris).

Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).

Some common antidepressants are fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).

Remember to always talk to your doctor first before taking any psychiatric medication to ensure it is safe and effective to do so.

If you think you may be suffering from some of the symptoms of this condition, then you may benefit from therapy. Feel free to reach out to your doctor or local mental health clinic to see what your available options are and to see if there is any sort of discount or promo code available to help you with the costs of treatment, as well as if your health insurance will cover treatment costs.


  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

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